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CURRENT SCIENCE REVIEWS by Joe Bruman January 1997 P.1 of 2 Klatka L et al; Neur 1996;47:1148-1152: Retrospective incidence of depression, hallucinations, and delusions in 28 subjects with Diffuse Lewy Body Disease, 56 with Alzheimer's Disease, and 28 autopsied Parkinson's patients. Hillen M, Sage J; Neur 1996;47:1180-1183: Counted nature and frequency of nonmotor "off" fluctuations (autonomic, sensory, cognitive/psychiatric) in 130 PD patients who had motor fluctuations. Modified treatment improved symptoms in 9 of the 22 who also had nonmotor fluctuations. Busenbark K et al; Neur 1996;47:1331-1332: Essential tremor (ET) is the most common movement disorder seen in clinical practice. Authors tried methazolamide in a controlled test against voice tremor in 9 patients, but it didn't work. Taha J et al; J Neurosurg 1996;85:1005-1012: Authors used microrecording during pallidotomy of 38 patients to study kinesthetic cells of the globus pallidus. Fisher N; BMJ 16 Nov 1996:1262 and O'Sullivan D: BMJ 16 Nov 1996:11262: Clozapine (Clozaril) is effective against otherwise resistant schizophrenia, but patients must be monitored for potentially fatal agranulocytosis. However for black patients the normal white cell and neutrophil counts may be at or below the alarm level. Since the incidence of schizophrenia in blacks of the area studied is four times that in whites, authors suggest lowering the alarm level to avoid denial of this treatment. BMJ 23 Nov 1996:1313 (news item): The gene locus recently found by US workers in a related cohort of PD patients may be present in only a small fraction of all PWP. Hawkes, C; BMJ 23 Nov 1996:1278: Comment on the recent US discovery of a PD gene: 98% of PD patients have no family history, therefore genetic origin is not certain. Praamstra P et al; Brain; 1996:119:1689-1704: Authors compared reaction times with recorded movement-related potential in a standard task, concluding that preprogramming a response required more effort by PD patients than by controls. Elble R et al; Brain 1996;119:1705-1716: Gait impairment of PD, called lower-half parkinsonism, is caused by impaired generation of shifts between steady-state postures or movements. Guridi J et al; Brain 1996;119:1717-1727: Nineteen suffering Macaque monkeys, under various regimes of induced PD and surgery, were used to determine that hyperactivity of the subthalamic nucleus is paramount in the pathophysiology of parkinsonism. STN surgery (thalamotomy) confers major improvement in all features of parkinsonism, except for levodopa-induced dyskinesia, and authors recommend that it receive more attention. CURRENT SCIENCE REVIEWS by Joe Bruman January 1997 p.2 of 2 Science, 6 December 1996:1612 (news item): The neurotransmitter glutamate in excess is toxic to neurons. Researchers in ALS (Lou Gehrig Disease) found in some cases a genetic defect in the protein that normally neutralizes glutamate. Tsukada H et al; J Neurosci 1996;16:7670-7677: Authors dosed rats with cocaine, then measured binding potential of D1 and D2 dopamine receptor antagonists by high-resolution PET scan, concluding that binge pattern cocaine may alter availability of binding sites. Murphy B et al; J Neurosci 1996;16:7768-7775: An anxiogenic inverse agonist raises dopamine turnover in the prefrontal cortex of rats and monkeys but not elsewhere, and the increased turnover impairs prefrontal-dependent cognitive tasks. Authors tested various drugs in the ventral tegmental area which block the increase, and prevented the cognitive deficit, suggesting that the VTA is an important regulatory site. Todd R et al; J Neurosci 1996;16:7776-7782: Authors observed time-dependent changes in D2, D3, and D4 binding in MPTP-denervated baboons, whose ipsilateral dopamine content was reduced by over 90%. Over a course of 480 days, Dopamine receptor binding first decreased, then increased up to 7-fold, then returned to near baseline levels, suggesting that MPTP-induced changes are complex. Cass W; J Neurosci 1996;16;8132-8139: Chronic methamphetamine intake can induce long-term deficits in striatal dopamine and serotonin. Since glial cell line-derived neurotrophic factor (GDNF) can partially protect against MPTP, authors tried it on rats given methamphetamine. GDNF selectively protected the dopamine neurons but not the serotonin neurons. Przedborski S et al; Neur 1996;47:1358-1359: Perinatal or neonatal hypoxic/ischemic brain injury in rats causes subsequent loss of striatal dopamine receptors, leading to hemi- parkinsonism/hemiatrophy. PET scan revealed cortical damage as well, but PET scan of a human subject with that syndrome showed no change in striatal dopamine receptors. Golbe L et al; Ann Neur 1996;40:767-775: Further statistical analysis of the large Italian-American family with 60 PD members reinforced autosomal dominance, but with wide variation in age at onset (20-85yr) and in duration of survival after onset (2-20yr). Sanchez-Ramos J et al; Arch Neur 1996;53:1265-1268: Up to 1/3 of PD patients in long-term treatment may hallucinate. Questionnaire interviews of 214 routine clinical visitors found 55 who complained of hallucinations related to PD. J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403